Dr. Christopher Bray MD PhD

My vision for ideal medical care is a partnership between the physician, patient, and expanded healthcare team that tackles the root causes of chronic disease and tries to reverse and prevent these problems.

Tuesday, December 25, 2018

Magnusdottir et al. [56] have systematically explored the genomes of 256 common gut bacteria for the presence of biosynthetic pathways for eight B vitamins, namely biotin, cobalamin, folate, niacin, pantothenate, pyridoxine, riboflavin, and thiamin. This allowed the authors to predict the proportion of each phylum containing potential producers of each vitamin. Some genomes contained all eight pathways, others none. The most commonly synthesised vitamins were riboflavin (166 potential producers) and niacin (162 producers). For riboflavin and biotin, virtually all microbes from the phyla Bacteroidetes, Fusobacteria and Proteobacteria possessed the necessary pathways, with a much smaller proportion of the Firmicutes and Actinobacteria having the potential for vitamin B biosynthesis. In the case of vitamin B12, all the Fusobacteria, compared with 10–50% of the other four phyla were predicted to be producers. Overall, Bacteroidetes appeared to be the phylum with the greatest number of predicted B vitamin producers. Excluding vitamin B12, over 90% of Bacteroidetes were predicted to be producers.

Alcoholism contributes to nearly half of liver cirrhosis-related deaths in the United States. Chronic alcohol abuse is also known to alter the intestinal microbiome, a community of bacteria, fungi, and viruses that coexist in the gut and help maintain immunological and metabolic homeostasis. Whether microbial fluctuations contribute to liver disease in chronic alcohol users is unclear, and the effect of changing intestinal fungal populations has not been previously studied.

This week in the JCI, a study led by Bernd Schnabl connects alcohol-driven changes in the fungal microbiome to liver disease. The research team at the University of California San Diego discovered that chronic alcohol intake increased fungal populations in the intestine as well as levels of the fungal structural molecule β-glucan in the bloodstream of mice. The latter result reaffirms prior findings that alcoholism increases the permeability of the intestine and permits gut microbes to leak into circulation. Further investigation revealed that fungal β-glucan activates an immune system receptor called CLEC7A on liver-dwelling immune cells, stimulating a pathway that provokes liver inflammation. Treating mice with anti-fungal agents prevented alcohol-induced fungal overgrowth and reduced signs of liver disease. The findings of this study support further research into the fungal microbiome's role in alcohol-related liver damage.

Friday, December 21, 2018

Over the past 20 years, research has shown that girls, and possibly also boys, have been going through puberty earlier and earlier. This is troubling news because scientists have linked the early onset of puberty with greater risk of mental illness, breast and ovarian cancer in girls and testicular cancer in boys.

Early puberty, also known as precocious puberty, is defined as developing breasts and starting periods before the age of eight. The average age for girls is 11. Starting before the age of eight also causes social trouble for young girls, including a heightened tendency towards risky behaviour, explains Harley.

The chemicals in question — phthalates, parabens and phenols — are known as endocrine disrupters, which may mimic hormones and lead children to mature well before their natural time. As the study noted, exposure to these chemicals is widespread, which is why it's crucial parents be made aware of the findings.

Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two of the most common diseases of the gastrointestinal tract. In new work, Vich Vila and colleagues have characterized the gut microbiota composition of both disorders using shotgun metagenomic sequencing of stool samples from 1792 individuals. Analyses involving bacterial taxonomy, metabolic functions, antibiotic resistance genes, virulence factors, and bacterial growth rates showed key differences between these two gut disorders. On the basis of gut microbiota composition differences, patients with IBD could be distinguished from those with IBS.

Thursday, December 20, 2018

A looming public health threat in this country is the primary care physician shortage. It's getting worse; we need to act quickly. According to the Annals of Family Medicine,[1] we're going to need an additional 52,000 primary care doctors by the year 2025.

Primary care is the foundation of preventive healthcare, one of the most complex areas in all of medicine. And good primary care is a surefire way to keep healthcare costs down.

Monday, December 17, 2018

The researchers used a drug known as interferon alpha to create a model of the syndrome and found that patients whose immune response to treatment was hyperactive or exaggerated were more likely to then develop severe fatigue.

"For the first time, we have shown that people who are prone to develop a CFS-like illness have an overactive immune system, both before and during a challenge to the immune system," said Alice Russell of King's College London's Institute of Psychiatry, Psychology & Neuroscience (IoPPN), who led the work.

Monday, December 10, 2018

Once again, your mother was right. You really do need to eat your vegetables. And while you are at it, put down the bacon and pick up the olive oil, because new research supports the contention that switching to a Mediterranean diet could significantly decrease the risk of heart disease.

According to a study published Friday in JAMA Network Open, people who followed this type of diet had 25 percent less risk of developing cardiovascular disease over the course of 12 years.

Conclusions and Relevance A higher frequency of organic food consumption was associated with a reduced risk of cancer. If these findings are confirmed, further research is necessary to determine the underlying factors involved in this association.

Reptiles need UVB for biosynthesis of vitamin D, and other metabolic processes. Specifically cholecalciferol (vitamin D3), which is needed to for basic cellular / neural functioning as well as the utilization calcium for bone and egg production. The UVA wavelength is also visible to many reptiles and might play a signifiant role in their ability survive in the wild as well as visual communication between individuals. Therefore, in a typical reptile enclosure, a fluorescent UV a/b source (at the proper strength / spectrum for the species), must be available for many captive species to survive. Simple supplementation with cholecalciferol (Vitamin D3) will not be enough as there's a complete biosynthetic pathway that is "leapfrogged" (risks of possible overdoses), the intermediate molecules and metabolites also place important functions in the animals health. Natural sunlight in the right levels is always going to be superior to artificial sources, but this might be possible for keepers in different parts of the world.

Sunday, December 2, 2018

The most common situations in which information was withheld were not agreeing with the clinician's recommendation (MTurk, 45.7%; SSI, 31.4%) and not understanding the clinician's instructions (MTurk, 31.8%; SSI, 24.3%).

The five reasons most commonly indicated for participants not disclosing information were not wanting to be judged or lectured (MTurk, 81.8%; SSI, 64.1%), not wanting to hear how harmful their behavior is (MTurk, 75.7%; SSI, 61.1%), embarrassment (MTurk, 60.9%; SSI, 49.9%), not wanting the clinician to think they were difficult patients (MTurk, 50.8%; SSI, 38.1%), and not wanting to take up more of the clinician's time (MTurk, 45.2%; SSI, 35.9%).

"If patients are withholding information from clinicians as frequently as this research suggests, then clinicians are routinely not receiving the information that they need to provide high quality care to patients, especially sicker patients," the researchers conclude. They note that sicker patients were more likely to withhold information.

Saturday, December 1, 2018

Worldwide geographical data show an inverse relationship between cardiovascular disease and annual sunlight availability [18]. In a study conducted in the British Isles, 49 % of the variance in mortality from coronary heart disease was accounted for by mean annual sunshine hours as measured by the Meteorological Office [19]. However, placebo-controlled trials failed to show any benefit from vitamin D3 supplementation [20]. We propose that the benefit comes from Ch-S synthesis instead. In [16], it was proposed that the protein endothelial nitric oxide synthase (eNOS), along with sunlight, catalyzes sulfate production in erythrocytes, endothelial cells, platelets and keratinocytes in the skin. Thus, eNOS is a dual-purpose enzyme, producing sulfate when it is membrane–bound and producing nitric oxide when it is free in the cytoplasm. We hypothesize that the overuse of sunscreen has played a dual damaging role not only because sunlight catalysis is suppressed but also because the aluminum found in high-SPF sunscreens as an emulsifier actively disrupts eNOS' function [21]. eNOS is an orphan cytochrome P450 (CYP) enzyme [22], and aluminum is a known disruptor of CYP enzyme function through its displacement of the iron in the heme group [23]. Many other environmental toxicants also disrupt CYP enzymes, including mercury [24, 25], arsenic [26], cadmium [24], glyphosate [27, 28], and lead [25, 29].

Wednesday, November 28, 2018

Unlike in DiRECT, patients were allowed to take insulin at study onset (30% in the low-carbohydrate group and 46% in the usual care group). After 1 year, patients in the usual care group had no significant changes in study biomarkers.

Conversely, 60% of those in the low-carbohydrate group achieved an A1c level < 6.5 while taking no diabetes medications or metformin only. There was also a 12% weight loss, 24% reduction in triglyceride level, 18% increase in high-density lipoprotein cholesterol level, and 39% reduction in C-reactive protein level.

According to Sarah Hallberg, DO, the study's principal investigator and medical director of Virta Health and Indiana University Arnett's Medically Supervised Weight Loss Program, the 94% rate of reduction or outright cessation of insulin in this group is particularly noteworthy.

Sunday, November 25, 2018

Nearly 500 water utilities across the state tested positive for atrazine — a weed killer — which can lead to harmful health effects, according to a new report. The Environmental Working Group also found that utilities are testing water during times when the herbicide isn't being used as much — and that they may be lowballing the results.

Tuesday, November 20, 2018

The vibrations emanating from the OtoTech gently target two of the four fibers that carry data about body motion to the brain via a system of inner ear sensors called the vestibulocochlear nerve. "Two [of the four vestibulocochlear nerve fibers] go to the brain, two go to your reflexes," Owen said. The trick is to affect the former and not the latter.

"The working hypothesis is that [the vibration] causes a chaotic and noninformative stimulus to go to the brain. Somewhere, probably the cerebellum, there's a filtering mechanism that filters out noninformative sensed information. It's the reason you don't notice the shirt on your back right now," he said.

Sunday, November 18, 2018

The Nov. 1 death of Daniel Best, a pharmaceutical executive from Bay Village who led U.S. Department of Health and Human Services efforts to lower prescription drug prices, has been ruled a suicide, officials in Washington, D.C., said Thursday.

Police say Best was found "unresponsive" near the garage door exit of an apartment building in Washington, D.C.'s Navy Yard neighborhood at 5:25 a.m. on Nov. 1, and was pronounced dead by medical personnel who responded to the scene.

The city's Office of the Chief Medical Examiner on Thursday said Best died from "multiple blunt force injuries" and it ruled his death a suicide. It would not release further information.

A higher frequency of eating organic food was associated with a reduced risk for cancer, according to results from a large population-based observational study published online October 22 in JAMA Internal Medicine.

"Promoting organic food consumption in the general population could be a promising preventive strategy against cancer," conclude the authors, led by Julia Baudry, PhD, of the Center of Research in Epidemiology and Statistics Sorbonne Paris Cité.

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